The persistence in the human circulation of horse and human tetanus antitoxins

Smolens, Joseph; Vogt, A; Crawford, Mary N.; Stokes, Joseph

doi:10.1016/s0022-3476(61)80320-x

Cited by 27 publications

(6 citation statements)

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“…Although calculation of the elimination half-life of normalized antibody titers was not completely relevant in this study, we found a value of 28 days, which is in agreement with previously reported values (29,34). The half-life of P-HTIG is much longer than that reported for antibodies of equine origin (7 to 14 days) (16,34).…”

Section: Discussionsupporting

confidence: 91%

“…In addition, a protective level was maintained for only 1 to 2 weeks (34), and doses of 1,500 to 3,000 IU were required. All these issues led to the subsequent development of human tetanus immunoglobulins, which at its current recommended dose of 250 to 500 IU has proven to be well tolerated and provides better protective levels of circulating antibodies for much longer periods than does heterologous immunoglobulin (34).…”

mentioning

confidence: 99%

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Evaluation of the Safety and Pharmacokinetic Profile of a New, Pasteurized, Human Tetanus Immunoglobulin Administered as Sham, Postexposure Prophylaxis of Tetanus

Forrat

Dumas

Seiberling³

et al. 1998

Antimicrob Agents Chemother

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In a monocentric, double-blind, randomized trial, we examined the safety and pharmacokinetic profile of a new, pasteurized, human tetanus immunoglobulin (P-HTIG). As part of the purification process, P-HTIG has undergone a heat treatment step (10 h at 60°C) and the removal of Merthiolate. Forty-eight adults with a history of tetanus vaccination were randomized into four groups (n = 12 per group) to receive one of two different batches of this P-HTIG simultaneously with either tetanus-diphtheria (Td) vaccine (sham, postexposure prophylaxis of tetanus) or placebo. Local reactions at the injection site were followed for the first 3 days after injection, and systemic reactions were followed during the entire study period, i.e., up to 42 days posttreatment. Blood samples for tetanus antibody titer determination (enzyme-linked immunosorbent assay method) were drawn prior to treatment on day 0 and on days 1, 2, 3, 7, 14, 21, 28, 35, and 42. A normalization of tetanus antibody titers (subtraction of the day 0 value for each subject at each time period) was performed to assess the additive effect of P-HTIG on tetanus antibody titers. The pharmacokinetic parameters were determined by both a compartmental analysis (modelization) and a noncompartmental analysis. No severe adverse reactions were reported. The rate of local reactions at the P-HTIG injection site was 27%. All local reactions were mild and resolved within 2 days. In contrast, local reactions at the vaccine injection site were seen in 79% of the subjects. The rate of systemic reactions was similar in the P-HTIG plus Td vaccine group (33%) and in the P-HTIG plus placebo group (21%), and all these reactions were mild. In the P-HTIG plus placebo group, tetanus antibody titers rose to a maximum of 0.313 ± 2.49 IU/ml after 4.4 days; in the P-HTIG plus Td vaccine group, a maximum concentration of 15.2 ± 2.42 IU/ml was reached 19 days postinjection. In both groups, 100% of the patients had seroprotective levels of tetanus antibodies (≥0.01 IU/ml) 2 days following treatment. An anamnestic response to Td vaccine appeared 7 days postimmunization. In conclusion, P-HTIG has a good safety and pharmacokinetic profile. Our results confirm that immunoglobulin should be associated with vaccine in the treatment of tetanus-prone wounds.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Evaluation of the Safety and Pharmacokinetic Profile of a New, Pasteurized, Human Tetanus Immunoglobulin Administered as Sham, Postexposure Prophylaxis of Tetanus

Forrat

Dumas

Seiberling³

et al. 1998

Antimicrob Agents Chemother

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show abstract

“…In man, limited experimeents showed no apparent alteration in antibody formation (Smolens et al, 1957), and Schwab and Fahey (1960) removed 62 units of plasma in 51 days from one case (final total, 230 units in 12 months) and 48 units in 30 days from another without ill effect. Clearly, however, normal plasma constituents, especially proteins, are removed, and although in our case the level of albumin remained constant, it is conceivable that normal globulins (particularly gamma-globulin) were depleted significantly, and since the liability to intercurrent infection in macroglobulinaemia is attributed to impaired antibody formation (Mackay et al, 1956), it is suggested that plasmapheresis should be reserved for rapidly progressive cases, particularly when, as in our case, haemorrhage is a prominent feature.…”

Section: Discussionmentioning

confidence: 90%

Treatment of Macroglobulinaemia

Conway¹,

Walker²

1962

BMJ

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“…À partir des années 1960, du fait des programmes de vaccination systéma-tique et du développement des dons du sang, il devint possible de disposer d'immunoglobulines humaines enrichies en anticorps antitétaniques. Ces préparations se révélèrent plus efficaces parce que les IgG humaines ont une demi-vie plus longue que les IgG équines, d'où une couverture prolongée, et qu'elles sont surtout beaucoup mieux tolérées que les sérums équins [7,8]. Elles se sont donc imposées malgré leur coût plus élevé et ce sont elles qu'on utilise encore de nos jours.…”

Section: éVolution Vers L'utilisation D'anticorps Neutralisants D'oriunclassified

De la sérothérapie aux anticorps recombinants « nus »

Watier

2009

Med Sci (Paris)

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The persistence in the human circulation of horse and human tetanus antitoxins

Cited by 27 publications

References 4 publications

Evaluation of the Safety and Pharmacokinetic Profile of a New, Pasteurized, Human Tetanus Immunoglobulin Administered as Sham, Postexposure Prophylaxis of Tetanus

Evaluation of the Safety and Pharmacokinetic Profile of a New, Pasteurized, Human Tetanus Immunoglobulin Administered as Sham, Postexposure Prophylaxis of Tetanus

Treatment of Macroglobulinaemia

De la sérothérapie aux anticorps recombinants « nus »

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